Endoscopes are well-known in the art and are flexible devices that are inserted into a natural body orifice such as the mouth or anus to provide visual and surgical access to portions of the upper and lower gastrointestinal (GI) tract. Endoscope accessible portions of the lower GI tract, for example, extend from the anus to the small intestine, and during this journey, the flexible endoscope must traverse a torturous, collapsed path through the anus, the rectum, and through the large intestine to the ileocecal opening of the small intestine. The torturous path includes an “S” shaped passage through the rectosigmoid junction and the sigmoid colon, and around several larger than right angled bends of the splenic flexure and hepatic flexure. Additionally, in small bowel enteroscopy, an endoscope must traverse a large torturous convoluted path having multiple “S” shaped passages.
Before insertion of the endoscope, the patient is given drugs to purge matter from the GI tract. Once emptied, the tubular walls of the large intestine can flatten or collapse together into a flattened tubular configuration. The collapsed intestines may inhibit passage of the flat face of the distal end of the endoscope, and the collapsed tissue can inhibit visualization by pressing against or near to a camera mounted within the flat face. To enhance the passage of the endoscope through the collapsed lumen and to improve visualization, insufflation gas is routinely pumped into the patient's GI tract to expand and distend the collapsed tubular tissues. This is the case for both upper and lower GI tract endoscopic procedures. The expanded walls improve visualization and reduce tissue contact with the flat face of the endoscope as it is pushed farther and farther into the insufflated GI tract. The distal portion of the endoscope is steerable, and the insufflated tissue can provide room for the surgeon to visually steer the endoscope through the path ahead.
While insufflation enables the practitioner to better visualize the internal anatomy, it introduces a number of risks to the patient while also increasing the time and cost associated with the endoscopic procedure. The administration of insufflation gas is painful and can cause lengthening of the anatomy and spontaneous perforation. Patients are anesthetized during the procedure and require recovery time, while in the care of the medical facility, to awaken from the anesthesia and purge the insufflation gas. CO2 is commonly used for insufflation as it is more readily absorbed through the patient's intestinal wall to reduce the post-operative recovery time. CO2 gas control systems, CO2 tanks, and CO2 gas heaters must be purchased and maintained in order to provide CO2 as an insufflation gas, adding to the expense of the procedure.